The technique of continuous ambulatory peritoneal dialysis (CAPD) for patients with chronic kidney disease or kidney failure is now well known. In this technique, metabolic waste products and excess electrolytes and other materials are washed from the body on a continuous basis by fluid infused into the peritoneal cavity, using the peritoneal membrane as a dialyzing membrane. The fluid for dialysis is introduced into the peritoneal cavity by a transabdominal connection. By virtue of the introduction of this artificial connection to the peritoneal cavity, these patients are exposed to an increased risk of peritoneal inflammation or peritoneal infection, commonly referred to as peritonitis.
In addition, large numbers of patients present themselves to emergency rooms complaining of abdominal distress and demonstrating other evidence of infection. In these patients, too, the differential diagnosis of peritonitis from other abdominal pathology is of timely importance.
Acute inflammation and infection has been known to be associated with increased numbers of granulocytic leukocytes in the peritoneal fluid. A routine laboratory procedure for detecting increased levels of peritoneal leukocytes uses microscopy techniques which require expensive instrumentation and technical expertise. Similarly, the presence of an infection has been routinely detected by microbial culturing, which commonly requires a 24-48 hour incubation period. During this incubation time, serious complications or extensive progression of the disease state can occur, further exacerbating the patient's condition or forcing the physician to treat the patient on the basis of incomplete information. It would therefore be desirable to have a rapid, inexpensive test for peritoneal inflammation and infection which requires no instrumentation, which can be performed by untrained personnel, and which could, if desired, be performed at the bedside or in the home, so that CAPD patients could be routinely monitored for complications.